Longitudinal Analysis of Substance Use Disorder Symptom Severity at Age 18 Years and Substance Use Disorder in Adulthood
McCabe SE, Schulenberg JE, Schepis TS, et al. Longitudinal Analysis of Substance Use Disorder Symptom Severity at Age 18 Years and Substance Use Disorder in Adulthood. JAMA Netw Open. 1 Apr 2022;5(4):e225324.
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2790601
Editorial Comment:
Volkow ND, Wargo EM. Severity of Adolescent Substance Use Disorders and Long-term Outcomes. JAMA Netw Open. 1 Apr 2022;5(4):e225656
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2790603
“McCabe et al. used data from 11 cohorts of high school seniors surveyed in the annual nationwide National Institute on Drug Abuse–funded Monitoring the Future study from age 18 years (study years 1976-1986) to age 50 years. They found that most of the individuals who had severe substance use disorder (SUD) when surveyed in high school still had 2 or more SUD symptoms in midlife. Those with the highest-severity SUD in adolescence had the highest likelihood of prescription drug misuse decades later.”
“The McCabe et al study necessarily leaves some questions unanswered. The use and misuse of prescription stimulants, which are among the prescription drugs most frequently misused by adolescents, were not investigated. Furthermore, smoking history was not studied as a variable, even though there is evidence that nicotine use may potentiate the rewarding properties of other drugs and could be associated with SUD trajectories in the transition from adolescence to adulthood. (Emphasis added) Future studies that look at stimulants and nicotine would help clarify the interesting picture about lifetime SUD that McCabe et al. have painted with their important study.”
Comment: Dr. Nora D. Volkow is the director of the US National Institute on Drug Abuse and has studied how nicotine and alcohol affect brain function and the trajectory of substance use because of such changes to brain function.
Stephen Hamann
